Provider Demographics
NPI:1609020858
Name:RUFLEDT, WENDY NOEL (OTR/L)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:NOEL
Last Name:RUFLEDT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5842 HOBE LN
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110
Mailing Address - Country:US
Mailing Address - Phone:651-383-1197
Mailing Address - Fax:651-383-1198
Practice Address - Street 1:5842 HOBE LN
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-6477
Practice Address - Country:US
Practice Address - Phone:651-383-1197
Practice Address - Fax:651-383-1198
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103293225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist